Final Report > Chapter 27: Care of an Appropriate Standard > Introduction

Introduction

1 The term standard is in essence a neutral term. What we import into it here is an element of quality. Any level of performance can meet some standard. But the standard which we are concerned with is that which properly serves the interests of the patient. Thus we take the term `standard of care' to mean an agreement on what a patient is entitled to expect as good practice in a particular context, based on the best available evidence. A standard of care, therefore, sets the boundaries of what is good practice. It also, however, needs to be sufficiently flexible to allow for minimum standards and standards of exemplary practice to which a service can aspire. In this chapter we examine briefly the approach to standards of clinical care in the past, and we consider the impact of recent policy changes. We argue that the systems for setting and monitoring standards of clinical care can and should be further improved. We advocate a new approach to setting of standards for hospitals, and we set out proposals for a more rigorous and better co-ordinated system to monitor the performance of the NHS as a whole.